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Childhood eating behaviours, correlates and impact: results from a Danish population cohort

Childhood eating behaviours, correlates and impact: results from a Danish population cohort. Dr Nadia Micali MD, MRCPsych, PhD NIHR Clinician Scientist and Honorary Consultant Psychiatrist UCL Institute of Child Health N.Micali@ucl.ac.uk. Background.

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Childhood eating behaviours, correlates and impact: results from a Danish population cohort

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  1. Childhood eating behaviours, correlates and impact: results from a Danish population cohort Dr Nadia Micali MD, MRCPsych, PhD NIHR Clinician Scientist and Honorary Consultant Psychiatrist UCL Institute of Child Health N.Micali@ucl.ac.uk

  2. Background • Rates of feeding difficulties vary from 25% to 5% in infancy/childhood Chatoor 2002; Lindberg, Bohlin, & Hagekull 1991; Esparo et al. 2004 • Picky/fussy eating commonly researched problem (20%) (Jacobi et al.,2003; 2008) • Feeding/eating problems cause of great stress for parents & parental stress may itself exacerbate feeding difficulties Douglas 2000; Harris & Booth 1992

  3. Aims • To determine the prevalence of feeding behaviours previously identified in the literature at age 5; • To clarify the definition of feeding difficulties and their impact • To determine associations of feeding behaviours and childhood psychopathology

  4. Methods • Eating behaviour instrument developed from: • the Childhood Eating Behaviour Questionnaire (CEBQ) • Children’s Eating Behaviour Inventory (CEBI) • Stanford Feeding questionnaire • Final instrument: 41 items

  5. Eating behaviour questionnaire Please tick one box for each item and answer YES or NO in the last column for each item

  6. SampleCCCC2000 – 5-7 year follow-up Random sample: 3000 9 died 79 not contactable

  7. Gender, birth-weight, birth compl, gest. Age, APGAR: NS

  8. Socio-demographics • Median age: 6.1 years • Gender: Males (49.7%)

  9. Factor analysis • 41 items: 3 questions on impairment, 4 questions from Stanford Feeding questionnaire, 12 from CEBQ, 22 from CEBI • Promax factor analysis restricted to 5 factors (eigenvalue of >1.5)

  10. Factor analysis (I) • Factor 1: overeating/good eating (enjoys eating/takes food between meals/asks for food between meals/is interested in food/ always asking for food/given the chance would always have food in their mouth/given the choice would eat most of the time) • Factor 2: picky eating (at dinner I let my child choose the food they want from what is served/eats a limited variety of food/eats food only if prepared in specific ways/has strong food likes and dislikes/accepts new foods readily) • Factor 3: poor eating (I feed child if he/she doesn’t eat/ takes more than ½ hour to eat their meal/I feel confident my child eats enough (negative)/ my child eats quickly (negative)/I get upset when my child doesn’t eat/ my child has a big appetite (negative))

  11. Factor analysis (II) • Factor 4: delayed eating behaviours (chews food as expected for his/her age (negative)/ feeds himself as expected for his age (negative)/ my child gags at mealtime/I find our meals stressful/ uses cutlery as expected for his age (negative)/says when she/he is hungry (negative)/chokes at mealtime/lets food sit in her mouth/my child says when he/she is hungry (negative)) • Factor 5: snacking behaviours(asks for food which he/she shouldn’t have/ at home eats foods he/she shouldn’t have/ I let my child have snacks between meals/gets full before his meal is finished/cannot eat a meal if he has had a snack before)

  12. Did not map onto any factor

  13. How to determine presence/absence of behaviours and impact • Prevalence: Behaviour present at least sometimes i.e. a score of ≥3.5 • Impact: 3 impact questions

  14. Presence and impact of eating behaviours: factors

  15. Frequency and impact of eating behaviours: single items *reverse item

  16. Eating behaviours and psychopathology *:p<0.01, **:p<0.01, ***: p<0.05; _: denotes a cell where no association was hypothesised

  17. Summary • 5 eating behavioural patterns identified: overeating/good eating, picky eating, slow/poor eating, delayed eating behaviours, snacking • Picky eating: most common in ~7% - “emotional undereating”~ 27%

  18. Summary (II) • Picky eating, slow/poor eating associated with high impact • Picky eating associated with behavioural problems, PDD and functional somatic symptoms • Emotional undereating also associated with emotional disorders and functional somatic symptoms

  19. Conclusions • Behaviours identified are in line with previous reports • Picky eating is a relatively common behaviour and is importantly related with psychological outcomes and impact • Improved recognition of childhood eating problems might be important for paediatricians and child psychiatrists

  20. Next step • Look at child and parental predictors: -obstetric complications -parental psychiatric disorders (ED) -infancy data (including failure to thrive)

  21. Acknowledgements • Institute of Social psychiatry Danish “team”: Anne Mette Skovgaard Hanne Elberling Charlotte Rask Else Marie Olsen • Emily Simonoff

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